护士的感知领导行为与医院安全文化之间关系的调查：一项结构方程模型研究
Investigation of the Relationship Between Perceived Leadership Behaviours of Nurses and Hospital Safety Culture: A Study With the Structural Equation Model.
作者信息
Ünal Aysun, Yıldırım Nezaket, Öncel Selma
机构信息
Nursing Management Department, Kumluca Faculty of Health Sciences, Akdeniz University, Antalya, Turkey.
Nursing Management Department, Nursing Faculty, Akdeniz University, Antalya, Turkey.
出版信息
Int J Nurs Pract. 2025 Feb;31(1):e13324. doi: 10.1111/ijn.13324.
BACKGROUND
Work environments that support patient safety initiatives are important for quality service and patient outcomes. The relationship between the leadership behaviours of nurse managers and safety culture, which has the potential to support these initiatives, constitutes one of the most important knowledge gaps.
OBJECTIVES
The study aimed to determine the relationship between nurses' perceived leadership behaviours and hospital safety culture and the factors affecting them.
DESIGN
We tested the theoretical model using structural equation modelling with the AMOS 21 program.
METHODS
The research was conducted with 134 nurses in two public hospitals in the south of Türkiye. Data were collected between October and December 2021 using the Leadership Behaviour Questionnaire and the Patient Safety Culture Hospital Questionnaire. Descriptive statistical analysis used to evaluate the data of the study. Structural equation modelling analysis and confirmatory factor analysis performed to test the research hypotheses.
RESULTS
The study found that non-punitive attitudes towards the mistakes had a full mediating effect on overall perception of safety interaction with employee-oriented leadership and high-level hospital interventions (β = -0.510, 95% CI -1.006/-0.076), and change had partly mediating effect on overall perception of safety interaction with change-oriented leadership (β = -0.510, 95% CI -1.043/-0.053).
CONCLUSIONS
It is clear that if nurse managers are to improve the staff's patient safety culture, they should develop change-oriented leadership skills by identifying adverse events and risks and motivating staff to learn from errors without taking punitive measures. In this context, healthcare organizations should evaluate the leadership qualities of managers. Managers at all levels can make plans to develop leadership behaviours that will play a facilitating role in improving patient safety.
背景
支持患者安全倡议的工作环境对于优质服务和患者结局至关重要。护士长的领导行为与安全文化之间的关系有可能支持这些倡议，这构成了最重要的知识空白之一。
目的
本研究旨在确定护士对领导行为的认知与医院安全文化之间的关系以及影响它们的因素。
设计
我们使用AMOS 21程序通过结构方程模型对理论模型进行了测试。
方法
该研究在土耳其南部的两家公立医院对134名护士进行。2021年10月至12月期间使用领导行为问卷和患者安全文化医院问卷收集数据。描述性统计分析用于评估研究数据。进行结构方程模型分析和验证性因素分析以检验研究假设。
结果
研究发现，对错误的非惩罚性态度对与员工导向型领导和高层医院干预的安全互动总体认知具有完全中介作用（β = -0.510，95% CI -1.006/-0.076），并且变革对与变革导向型领导的安全互动总体认知具有部分中介作用（β = -0.510，95% CI -1.043/-0.053）。
结论
显然，如果护士长要改善员工的患者安全文化，他们应该通过识别不良事件和风险并激励员工从错误中学习而不采取惩罚措施来培养变革导向型领导技能。在这种情况下，医疗保健组织应该评估管理人员的领导素质。各级管理人员可以制定计划来培养在改善患者安全方面发挥促进作用的领导行为。
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